No abstract available.
Diagnosis* ; Magnetic Resonance Imaging* ; Spondylitis*

Female ; Humans ; Hyperostosis ; diagnosis ; Middle Aged ; Sacroiliitis ; diagnosis ; Spondylitis ; diagnosis ; Spondylitis, Ankylosing ; diagnosis

Spinal disc surgery has been the most common cause of iatrogenic disc infection, resulting in pyogenic spondylitis. The diagnosis is usually difficult because of the infrequency of occurrence of pyogenic spondylitis. If three or more vertebrae are involved, the diagnosis of osteomyelitis is unlikely to be correct. Especially involvement of multiple non-contiguous vertebrae indicates metastatic tumor. Therefore, we report a rare case of latent multiple non-contiguous pyogenic spondylitis following spinal surgery. The actual cause of infection in this case is unknown. CT guide biopsy may be needed to rule-out tuberculosis spondylitis and metastatic tumor in such case of multiple spinal involvement. In conclusion, the possibility of latent spinal infection must be considered even though surgery had been done several years ago.
Biopsy ; Diagnosis ; Osteomyelitis ; Spine ; Spondylitis* ; Tuberculosis

Pyogenic spondylitis and tuberculous spondylitis are common causes of spinal infection. It is difficult to differentiate tuberculous spondylitis and pyogenic spondylitis clinically and radiologically. Recently magnetic resonance imaging has been reported to be beneficial for early diagnosis and differential diagnosis of the spondylitis, and is being used extensively for diagnosis. However, the diagnosis must be considered in combination with corresponding changes in clinical manifestations, radiological findings, blood and tissue cultures and histopathological findings. Conservative treatments, including antimicrobial medications, are started initially. Surgical treatments, which include anterior or posterior approach, single-stage or two-stage surgery, with or without instrumentation, may be performed as indicated.
Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Magnetic Resonance Imaging ; Spondylitis*

STUDY DESIGN: A case report is presented of destructive lesion involuting intervertebral disc space and adjoing vertebral bodies in association with ankylosing spondylitis. OBJECTIVE: To report unusual clinical and radiological presentation of spondylodiscitis and its treatment wi th anterior interbody fusion. SUMMARY OF BACKGROUND DATA: Althought there is some mention in the literature of pathogenesis, diagnosis and treatment of spondylodiscitis in ankylosing spondylitis, we think that its occurrence is frequent enough to warrant this condition and we should differentiate it from other infectious or tumorous condition. RESULTS: Anterior debridement and anterior interbody fusion with structural bone graft were performed. The microscopic study showed nonspecific chronic inflammation and extensive necrosis. CONCLUSION: It was suggested that primary spondylodiscitis or pseudoarthrosis resulted from mechanical trauma be related to this condition rather than infectious spondylitis.
Debridement ; Diagnosis ; Discitis ; Inflammation ; Intervertebral Disc ; Necrosis ; Pseudarthrosis ; Spondylitis ; Spondylitis, Ankylosing* ; Transplants

PURPOSE: We wanted to evaluate the diagnostic value of the various findings on sacroiliac CT for detecting the early changes of ankylosing spondylitis (AS). MATERIALS AND METHODS: Between April 2005 and March 2006, 51 sacroiliac CT images with the clinical suspicion of AS, but no definite evidence of AS on the plain radiograph only, were retrospectively reviewed. Finally, 36 patients (mean age: 28.6 years; 34 males and 2 females), who were clinically diagnosed as AS (AS group, n=26) or they had no evidence of AS (non-AS group, n=10), were evaluated. Two musculoskeletal radiologists analyzed the presence of marginal irregularity, bony erosion and subchondral sclerosis. A statistical analysis was performed to evaluate the incidence, sensitivity and specificity of each finding. RESULTS: Marginal irregularity was seen in 21 of 26 AS subjects, and in 8 of 10 non-AS subjects. Bony erosion was only seen in 13 of 26 AS subjects. Subchondral sclerosis was observed in 19 of 26 AS subjects and in 8 of 10 non-AS subjects. The sensitivity/specificity for each findings were 72.4%/28.6%, 100%/43.5% and 70.4%/22.2%, respectively. Except for bony erosions, these results showed no statistical significance (p=.006). CONCLUSION: Bony erosion on CT is a very sensitive finding for the early changes of AS, whereas marginal irregularity or subchondral sclerosis is not so helpful in differentiating AS from non-AS. Attention to these results may further enhance the accurate diagnosis of the early changes in AS.
Arthritis ; Diagnosis ; Humans ; Incidence ; Joints ; Male ; Retrospective Studies ; Sclerosis ; Sensitivity and Specificity ; Spondylitis ; Spondylitis, Ankylosing*

Reiter's syndrome is associated with a classic triad of arthritis, conjunctivitis, urethritis, and is the most common type of reactive arthritis. This syndrome is a one type of seronegative arthropathy, requiring differential diagnosis with psoriatic arthritis and ankylosing spondylitis, since it is associated with psoriasis-like skin lesion, sacroilitis, spondylitis. The arthritis of Reiter's syndrome is known to be acute, short-lived, and transient, but with subsequent attacks, it is more likely that it will lead to permanent joint damage or disability. We recently have experienced one case of Reiter's syndrome with severe joint destruction and significant functional disability, so here we report one case with review of literature.
Arthritis ; Arthritis, Psoriatic ; Arthritis, Reactive ; Conjunctivitis ; Diagnosis, Differential ; Joints* ; Skin ; Spondylitis ; Spondylitis, Ankylosing ; Urethritis

Tuberculosis is the chronic consumptive disease and currently the world's leading cause of death. Tuberculous spondylitis is a less common yet the most dangerous form of skeletal tuberculosis. The recent re-emergence of Mycobacterium tuberculosis (M. tuberculosis) hints at a possible resurgence of tuberculosis in the coming years. This article discusses the clinical manifestations, diagnosis and treatment of tuberculous spondylitis, and updates material that the author has previously published on the subject. Treatment should be individualized according to different indications which is essential to recovery. A treatment model is suggested on the basis of the author's vast personal experiences.
Cause of Death ; Diagnosis* ; Humans ; Mycobacterium tuberculosis ; Spine* ; Spondylitis ; Tuberculosis*

STUDY DESIGN: Infectious spondylitis patients were classified according to their cause in pyogenic and tuberculous and compared by each. SUMMARY OF LITERATURE REVIEW: Tuberculous spondylitis shows chronic clinical course and disc space sparing with much pus formation in radiologic finding compared to pyogenic spondylits. PURPOSE: To compare pyogenic and tuberculous spondylitis in clinical, radiological, pathological difference for appropriate management of infectious spondylitis. MATERIALS AND METHODS: We reviewed sixty two cases of infectious spondylitis confirmed by culture and pathologic findings of specimens which obtained by surgical method at the orthopaedic department of the Dong-A university hospital between June 1990 and November 1998. RESULTS: There were 18 cases of pyogenic and 44 cases of tuberculous spondylitis, and combined infection case was absent. Average period between beginning of symptom and diagnosis was 6.4 months in pyogenic spondylitis(4-11 months), 3.9 months in tuberculous spondylitis(3-39 months). The average number of affected vertebra was 2.3 in pyogenic spondylitis and 3.9 in tuberculous spondylitis. 6 cases of pyogenic spondylitis(33%) showed high fever(above 38degree C) which not presented in tuberculous spondylitis. We could not find considerable difference in leukocyte count, ESR, CRP level and simple radiologic finding, MRI finding between pyogenic and tuberculous spondylitis. CONCLUSIONS: In our study, most pyogenic spondylitis shows chronic and inactive feature, so clinical, radiological, laboratory findings are not appropriate guide to differentiate between pyogenic and tuberculous spondylitis. Culture growth of infecting agent and histologic examination are reliable and essential diagnostic method for pyogenic and tuberculous spondylitis.
Diagnosis ; Humans ; Leukocyte Count ; Magnetic Resonance Imaging ; Spine ; Spondylitis* ; Suppuration

Intravertebral vacuum cleft in collapsed vertebra was considered as a typical finding of avascular necrosis. However, several authors reported some cases of intravertebral vacuum cleft in primary or secondary neoplasm, or in spondylitis emphasiging the differenhal diagnosis. MRI is known to be a useful diagnostic modality for diferentiation between benign and malignanct conditions causing vertebral collapse. We report MRI findings of two cases with intravertebral vacuum cleft diagnosed as posttraumatic collapse with avascular necrosis on radiological and clinical bases.
Diagnosis ; Magnetic Resonance Imaging ; Necrosis ; Spine ; Spondylitis ; Vacuum*